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A Committee Consults: The Care of an Anencephalic Infant

Creator

Berkowitz, Sheldon T.

Bibliographic Citation

Hastings Center Report. 1986 Jun; 16(3): 18-19.

Abstract

A hospital ethics committee's deliberations concerning the care of an anencephalic newborn are summarized. Because the defect was irreversible and rapidly lethal, resuscitation and mechanical ventilation were deemed not medically or legally required. The issue of providing fluids and nutrition was complicated: while tube feeding was possible, the infant was beginning to aspirate glucose water, in itself a possible cause of death. Intravenous (IV) feeding might be painful, but could an infant without higher brain structures experience pain? The committee also considered the emotional impact of withholding such treatment on the nurses and family. In the end, no consensus was reached on the issue of withholding fluids and nutrition. The author concludes that the priority concerns, when a decision is made to withhold support from a terminally ill infant, are to avoid pain to the infant and to provide emotional support to the family and staff. (KIE abstract)